This is a paper written by John C. Lee, Jr., SRN from the east side of the country. I am grateful that he shared it with me, because he captured the desire to become a flight nurse and quite a lot of useful information for those interested in the field. Reprinted with permission.
Flight Nurse: A Life of Training and Trauma.
As I have yet to begin my formal training for a nursing career, reflecting on a specific role within nursing is a guilty pleasure. However, I realize that in today’s world, it is never too early in an educational pursuit to think about long-term career goals. Without any experience in the field, this exercise is very much a reflection of what I currently feel based on my own thoughts and research knowledge. As with all things, life is dynamically fluid, and my future experiences will bring opportunities and changes in my career. For now I will let my mind fly toward the blue skies of a flight nurse.
Every few weeks, I pull into the parking area at CMMC to view the rays of sun dancing on the smooth shinny metal body of the Lifeflight helicopter. One day I was lucky enough to see the blades of the chopper slowly turning, getting faster and faster as I smelled the jet fuel and heard the wind whistle past my ears; out of the hospital, running past me were the nurses and paramedics in their blue jumpsuits and helmets. They hopped aboard, then flew off at top speed in their fully equipped flying emergency room, ready to land on the road or in a field to pick up a trauma patient in desperate need of care. I knew that both the helicopter and nurses would be operating at top speed to get the patient stable in the crucial “Golden Hour” and beat back death. The chance to fly, be a part of a highly trained team, along with being able to help stabilize and give a trauma patient the chance to live, seems like a career I would love. In my exploration into the world of a flight nurse, I found it to be a career built around a life of training and trauma.
The field of flight nursing was born out of trauma: the need to get critically ill patients to a hospital quickly in order to offer the best chance for survival. More specifically, World War II created this new career for nurses. According to Lambert & Lambert (2005):
When the war began it was thought that only cargo or bomber aircraft would be used to transport sick and wounded soldiers. Thus since enlisted men in the Medical Corps were taught first aid, it was not considered necessary to assign nurses to accompany the wounded while being transported in an aircraft. However this policy quickly changed with the establishment of a Nursing Division in the Air Surgeon’s Office for the development and special training of flight nurses. (pp. 34 -35)
Through each subsequent war, the need for flight nurses grew. Around 1971, the creation of emergency medical services, established the need for civilian flight nurses to transport the most critically ill and provide top-notch medical service in flight (Air & Surface Transport Nurses Association (ASTNA), 2007).
I quickly realized that a flight nurse is a lot more than just being a nurse, wearing a flight suit, and looking cool. Flight nursing combines the skills of intensive care, critical care, and emergency nursing. According to Scally (2002), “Some might argue that even more so than in other types of nursing, [in flight nursing] continuous training and experience matter” (p. 1). Flight nursing involves caring for the 10 percent of the most critically ill or injured patients across all specialties of medicine and disease process. Instead of just maintaining the patients during transport, flight nurses make onsite diagnoses and treatment decisions, providing care before the patients get to the hospitals (Scally, 2002). This requires an intense amount of training.
Requirements to be a flight nurse vary from state to state and program to program but nationally, all flight nursing programs require RN’s to have two to three years of critical care experience and advanced cardiac life support and pediatric advanced life support certificates. Other requirements may include a neonatal resuscitation program, a nationally recognized trauma program, and transport nurse advanced trauma courses. Certifications such as critical care registered nurse, certified emergency nurse, or certified flight registered nurse may also be required. Some states also require nurses to be paramedics or at least emergency medical technicians (ASTNA, 2007).
To meet my goal of becoming a flight nurse will require hard work, a huge time commitment, much training, and exposure to trauma. Aside from the possible adrenaline rush, what draws me to this career is the opportunity to learn so many varying and broad based skills. Through my short time being a lowly EMT-B, I have developed a great desire to continue to learn life-saving techniques and trauma skills. Along with the typical protocols, I will be forced to make diagnoses that will impact the patient for good or bad.
On a broad based level, I am already on a flight path toward my goals. As a voluntary EMT-B, I realize just how important it is to keep learning and moving forward with continuing training. In the next month, I will be taking a course in pre-hospital trauma life support for EMS providers. I am currently involved with volunteer work at Tri-Town Rescue, and have had exposure over the past several weeks ranging from traumatic motor vehicle accidents to working on a patient in full cardiac arrest. This summer I may even train for my EMT – intermediate level certificate.
In the short-term, I will focus my education in these areas along with graduating with my BSN. In the long-term, I will look for opportunities to meet the requirements needed in the critical care unit to learn and hone my technical skills along with my interpersonal skills. Through all this, I will continue to train and train and train toward my goal of applying for and securing a job as a flight nurse. This will not be an easy task. According to the ASTNA (2007), there are about 3,000 civilian flight nurses in the United States. There are more nurses wanting to be flight nurses than there are jobs. According to Scally (2002), “Turnover in most flight nursing programs are very low. However, you can find a job as a flight nurse if you’re willing to move to any area of the country as jobs become available, be persistent, and continue to obtain more advanced training” (p. 2). I am finding out that anything worthwhile in life is a process of persistence.
Once I reach this highly specialized goal, what kind of money can I command? Research from Salary.com (2007), shows that the median expected salary is $56,326 for a flight nurse. The range is from a low of $52,184 to a high of $64,804. In comparison, the median expected salary for an emergency room nurse is $56, 226, with the range at a low of $51,106 to a high of $61,644. Initially, I was shocked to see that at the median range the salary difference is approximately a hundred dollars. All this extra training for what seems such a small amount of pay? This can be attributed to two factors. The first is that in general nursing salaries are low compared to other high-end professions, and the second is the simple theory of economics: supply vs. demand. With so many willing nurses and so few slots available, the market controls salaries. In the end, it is not the appeal of money, it is the professional challenge that draws many nurses to flight nursing.
I know for me it is the overall challenge of nursing that draws me toward the profession, with a long-term horizon of critical care flight nursing. Hudson (2001) states, “Flight nursing has the intensity of ICU with the urgency of an emergency department. It is the ultimate challenge, the relationships formed are professional, yet intensely intimate at the same time” (p. 230). I can think of no other job that allows room for both professionalism and intimacy. This is why I can allow my mind to fly toward the skies of flight nursing. Whatever my career in nursing brings, I am sure it will bring challenges, relationships, professionalism, and intimacy. I can only hope that time and persistence will bring a flight helmet and jumpsuit to me.
Air & Surface Transport Nurses Association. (n.d.). ASTNA answers frequently asked questions. Retrieved February 19, 2007, from http://www.astna.org/FN-FAQ.html
Hudson, J. (2001). Trauma junkie: Memoirs of an emergency flight nurse. Buffalo, NY: Firefly Books.
Lambert, V. and Lambert C. (2005). The evolution of nursing education and practice in the U.S. In J. Daly, S. Speedy, D. Jackson, V. Lambert, & C. Lambert. (Eds.), Professional nursing: Concepts, issues, and challenges (pp. 34-35). New York: Springer Publishing Company.
Salary.com. (n.d). Salary.com nursing salaries. Retrieved February 19, 2007, from http://www.salary.com/sitesearch/layoutscripts/sisl_display.asp?searchtextvalue=ed+nurse&Image1.x=0&Image1.y=0
Scally, R. (2002). Flight nurses: Nursing’s high altitude calling. Spotlight on nurses. Retrieved February 19, 2007, from http://www.nursezone.com/student_nurse_center/default.asp?articleId=9674